Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Front Immunol. 2023 Dec 18;14:1259094. doi: 10.3389/fimmu.2023.1259094. eCollection 2023.
Kawasaki disease (KD) is a common systemic vasculitis of childhood. Although it has been almost 6 decades since Dr. Tomisaku Kawasaki reported the first case series of KD, the underlying cause remains a mystery. KD is a self-limiting disease. However, a dreaded complication is development of coronary artery abnormalities (CAAs). KD is the most common cause of acquired heart disease in children in the developed world and is being increasingly reported from developing countries too. Over the years, significant observations have been made about epidemiology of KD. It usually affects children below 5, has male preponderance and has significantly higher incidence in North East Asian countries. While several hypotheses have been proffered for etiology of KD, none have been conclusive. These include associations of KD epidemics in Japan and the United Stated with changes in tropospheric wind patterns suggesting wind-borne agents, global studies showing peaks of incidence related to season, and increased rates in populations with a higher socioeconomic profile related to hygiene hypothesis and vaccination. Furthermore, the self-limiting, febrile nature of KD suggests an infectious etiology, more so with sudden decline noted in cases in Japan with onset of COVID-19 mitigation measures. Finally, single nucleotide polymorphisms have been identified as possible risk alleles in patients with KD and their significance in the pathogenesis of this disease are also being defined. The purpose of this review is to elucidate the puzzling associations of KD with different environmental factors. Looking at patterns associated with KD may help us better predict and understand this disease.
川崎病（KD）是一种常见的儿童全身血管炎。尽管自川崎富作博士报告首例 KD 病例系列以来已经过去了近 60 年，但病因仍然是个谜。KD 是一种自限性疾病。然而，一个可怕的并发症是冠状动脉异常（CAA）的发展。KD 是发达国家儿童后天性心脏病的最常见原因，在发展中国家也越来越多地被报道。多年来，人们对 KD 的流行病学进行了大量观察。它通常影响 5 岁以下的儿童，男性居多，在东北亚国家的发病率明显较高。虽然已经提出了几种关于 KD 病因的假说，但没有一种是结论性的。这些假说包括日本和美国的 KD 流行与平流层风模式变化之间的关联，表明有风媒病原体；全球研究显示与季节相关的发病率峰值；以及在卫生假说和疫苗接种相关的高社会经济水平人群中发病率增加。此外，KD 的自限性、发热性质表明其具有传染性病因，尤其是在日本因 COVID-19 缓解措施而发病的病例中，其发病率突然下降。最后，单核苷酸多态性被确定为 KD 患者的可能风险等位基因，其在该疾病发病机制中的意义也正在被定义。本综述的目的是阐明 KD 与不同环境因素之间令人费解的关联。研究与 KD 相关的模式可能有助于我们更好地预测和理解这种疾病。
